吸烟及糖皮质激素对慢性阻塞性肺疾病患者肺泡巨噬细胞凋亡的影响  

Effects of smoking and glucocorticoid on alveolar macrophage apoptosis in patients with chronic obstructive pulmonary diseases

作　　者：曹国强[1] 钱桂生[1] 姬军生[1] 林海龙[1] 谢志坚[1] 

机构地区：[1]解放军第三军医大学

出　　处：《中国临床康复》2005年第35期92-93,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的：探讨慢性阻塞性肺疾病患者肺泡巨噬细胞凋亡特点及其影响因素。 方法：①收集2002-12／2003-12解放军第三军医大学大坪医院野战外科研究所呼吸内科门诊接受纤维支气管镜检查患者21例。11例患者经 肺功能检查证实为慢性阻塞性肺疾病(患者组)，男6例，女5例，均为吸烟者，平均吸烟指数300年支。设未被证实为慢阻肺患者10例为对照组，男7例，女3例，均无吸烟史。纳入患者均对实验目的知情同意。②经支气管肺泡灌洗获取肺泡巨噬细胞。利用髓过氧化物酶染色法观察肺泡巨噬细胞的染色阳性率。利用原位末端标记法观察支气管肺泡灌洗液中肺泡巨噬细胞凋亡的变化和地塞米松的对其凋亡的影响。凋亡率=凋亡细胞数／细胞总数×100％。③计量资料差异比较采用双尾t检验分析。 结果：慢性阻塞性肺疾病患者11例和非慢性阻塞性肺疾病患者10例均进入结果分析。①患者组肺泡巨噬细胞的髓过氧化物酶染色阳性率明显低于对照组[(0．8±0．3)％，(1．2±0．4)％，P<0．05]，支气管肺泡灌洗液中肺泡巨噬细胞凋亡率明显低于对照组[(1．9±0．7)％，(4．8±1．3)％，P<0．01]。②地塞米松处理12和24及48h后的肺泡巨噬细胞凋亡率明显高于对照组[(9．2±2．3)％，(35．4±12．6)％，(45．8±9．2)％；(5．9±1．8)％，(10．8±2．7)％，(24．1+4．6)％，P<0．01]。 结论：①吸烟可能导致慢性阻塞性肺疾病患者的气道和肺泡腔中肺泡巨噬细胞凋亡率下降的一个重要因素。该种作用使肺泡巨噬细胞对凋亡中性粒细胞的吞噬能力下降，以上变化可能参与了慢性气道炎症的形成。②糖皮质激素能够诱导慢性阻塞性肺疾病患者肺泡巨噬细胞的凋亡，对防止炎症反应的形成有意义。AIM： To investigate the feature of the apoptosis of alveolar macrophage and its effects in patients with chronic obstructive pulmonary disease （COPD）. METHODS： ① Twenty-one patients, who were treated with fiberoptic bronchoscopy at out-patient clinic of Department of Respiratory Medicine, Institute of Battle Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from December 2002 to December 2003, were selected. Eleven patients were diagnosed with COPD by pulmonary function test, including 6 males and 5 females, and they were smokers with average smoking index of 300 year ·cigarette. Ten people who were not diagnosed with COPD were considered as control group, including 7 males and 3 females, all without smoking history. The included patients were all agreed to take part in the experiment, ② The alveolar macrophages were gained with bronchoalveolar lavage. The staining positive rate of alveolar macrophage was observed with myeloperoxidase staining method. The apoptosis changes of alveolar macrophage in bronchoalveolar lavage and the effects of desacortone on apoptosis were observed with in situ end- labeling （ISEL）. Apoptosis rate = number of apoptosis/total number of cells ×100%. ③ The difference of measurement data was compared with two-tail t-test analysis. RESULTS： Eleven patients with COPD and 10 people without COPD were all involved in the result analysis. ① The myeloperoxidase staining positive rate of alveolar macrophage in patient group was significantly lower than that in the control group [（0.8±0.3）%,（1.2±0.4）%,P 〈 0.05]. The apoptosis rate of alveolar macrophage in bronchoalveolar lavage was significantly lower than that in the control group [（1.9±0.7）%, （4.8± 1.3）% ,P 〈 0.01]. ② The apoptosis rate of alveolar macrophage after the disposal of desacortone for 12, 24 and 48 hours was significantly higher than that in the control group [（9.2±2.3）%, （35.4±12.6）%, （45.8.±9.2）%; （5.9±1.8）%, （10.8±2.7）%, （24.1±

关 键 词：细胞凋亡 肺疾病 慢性阻塞性/病理生理学 巨噬细胞 肺泡 

分 类 号：R563.9[医药卫生—呼吸系统]